Block 5 Anat Triang Root Of Neck From Ta's W Expl Prt 2

18 Questions | By Chachelly | Last updated: Mar 20, 2022 | Total Attempts: 71

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1.

A Spanish surgeon is conducting the world's first ever face transplant surgery for a victim of gunshot wounds. In addition to other preparatory steps, the surgeon needs to ligate a major artery before proceeding with removal of tissue from the face. In which triangle should the surgeon start his surgical approach to gain access to this artery?
- A.
  
  Posterior triangle
- B.
  
  Submental triangle
- C.
  
  Submandibular triangle
- D.
  
  Carotid triangle
- E.
  
  Muscular triangle
2.

A 17 year old male sustains a stab wound to the upper left chest. He is brought into the emergency room with asymmetrical breathing and the physician suspects he has insufficient diaphragm movement on the left side. One would find the damaged structure passing over what landmark?
- A.
  
  Anterior to the anterior scalene muscle
- B.
  
  Between anterior and middle scalene muscles
- C.
  
  In a triangle bounded by both anterior digastric muscles
- D.
  
  Superficial to the sternocleidomastoid muscle
3.

A 25-year-old medical student presents to the Health Clinic with a lesion on the inferior medial vermillion (lip) border consistent with Staphylococcus aureus bacterial infection. Upon examination, the physician finds enlarged lymph nodes. To which of the following groups of lymph nodes is this infection likely to drain first?
- A.
  
  Submandibular lymph nodes
- B.
  
  Submental lymph nodes
- C.
  
  Deep cervical lymph nodes
- D.
  
  Retropharyngeal lymph nodes
- E.
  
  Occipital lymph nodes
4.

A bodybuilder, after finishing his high-protein meal with a delicious protein smoothie, finds his arm in discomfort. More specifically, he has 9/10 pain on his right arm with a complete inability to flex his fifth digit. He concludes that his workout was particularly straining and that he must have compressed some nerve going to his hand. His physician agreed with his assessment, explaining that the nerve he compressed runs through a triangle of the neck formed by which of the following muscles?
- A.
  
  Sternocleidomastoid and omohyoid
- B.
  
  Stylohyoid and posterior belly of digastric
- C.
  
  Anterior and posterior bellies of digastric
- D.
  
  Scalene anterior and middle
- E.
  
  Scalene middle and posterior
5.

A metastatic lung cancer patient presents with recent-onset anhidrosis, miosis, and ptosis on the left side. He also has pain in his left arm. His oncologist is worried about this because it likely represents disease progression as indicated by tumor compression of which of the following?
- A.
  
  Right sympathetic trunk
- B.
  
  Left sympathetic trunk
- C.
  
  Right CN X
- D.
  
  Left CN X
- E.
  
  Left CN XI
6.

A metastatic lung cancer patient presents with recent-onset anhidrosis, miosis, and ptosis on the left side. He also has pain in his left arm. His oncologist is worried about this because it likely represents disease progression as indicated by tumor compression of which of the following?
- A.
  
  Right sympathetic trunk
- B.
  
  Left sympathetic trunk
- C.
  
  Right CN X
- D.
  
  Left CN X
- E.
  
  Left CN XI
7.

A 25-year-old bus rider is brought into the emergency room following a multi-vehicle accident involving the bus he was taking, a garbage truck, and a tractor that caused the bus to flip on its side. Among the many complaints with which this patient presents is a noticeable unilateral defect of inspiration and expiration with traumatic injury to his neck. The physician suspects that the problems of breathing are due to a lesion in which of the following areas of the neck?
- A.
  
  Submandibular triangle
- B.
  
  Carotid triangle
- C.
  
  Submental triangle
- D.
  
  Posterior triangle
- E.
  
  Muscular triangle
8.

A 46 year old male came into the clinic a few days after having surgery in the root of the neck and claimed it was hard for him to breath. The doctor investigated and found that the diaphragm is not contracting on the side he had surgery. The nerve that is damaged has what nerve roots?
- A.
  
  C2-C4
- B.
  
  C3-C5
- C.
  
  C4-C6
- D.
  
  C1-C3
- E.
  
  C5-C6
9.

A lesion to the chorda tympani nerve would result in what deficit?
- A.
  
  Loss of taste and pain/temp sensation to anterior 2/3 of tongue
- B.
  
  Loss of taste to posterior 1/3 of tongue
- C.
  
  Loss of taste to anterior 2/3 of tongue and parasympathetic activity to submandibular/sublingual glands
- D.
  
  Loss of pain/temp sensation to anterior 2/3 of tongue and parasympathetic activity to submandibular/sublingual glands
- E.
  
  Loss of taste and motor activity to anterior 2/3 of tongue
10.

A patient presents to the ER with a stab injury to the neck. You determine that the stab wound is quite large and is found posterior to the sternocleidomastoid, superior to the clavicle and anterior to the trapezius. Which motor nerve is at highest risk of damage?
- A.
  
  Lesser occipital nerve
- B.
  
  Vagus nerve
- C.
  
  Hypoglossal nerve
- D.
  
  Facial nerve
- E.
  
  Transverse cervical nerve
- F.
  
  Spinal accessory nerve
11.

A 54-yo, male, presents to your emergency clinic after being involved in a gang-related incident. He presents with multiple gun shot wounds to the chest and lacerations across his neck. An OR is quickly cleared for emergency surgery and the patient is successfully intubated and stabilized. As a vigilant medical student on your surgery rotation, you recall some of the vital structures in the anterior triangle of the neck proximal to some of the patient's lacerations. In particular you observe that the patient is having trouble swallowing and speaking because the muscles that depress and stabilize the hyoid bone are damaged. In particular, which of these muscles is innervated by a branch of the cervical plexus whose nerve only contains one spinal level contribution?
- A.
  
  Sternohyoid m
- B.
  
  Omohyoid m.
- C.
  
  Sternothyroid m.
- D.
  
  Thyrohyoid m
- E.
  
  Sternocleidomastoid m.
12.

Patient walks into the clinic complaining of irritation towards the back of the mouth. Being a sharp physician you make an automatic assumption. Thinking back to anatomy you remember what nerve pierces through the piriform recess and also remember that food may get stuck here. What nerve is it?
- A.
  
  Vagus nerve as it does not even divide before reaching the viscera
- B.
  
  Internal Laryngeal nerve.
- C.
  
  Glossopharyngeal nerve on its way to the Stylopharyngeus
- D.
  
  Optic nerve as it begins in the occipital lobe, tracks through the piriform and back up to the orbit
13.

You've started working out a lot since coming to the island because you want to impress your friends and family back home. You even start working out muscles you never have in the past, such as your scalenes. However, recently you've felt some tingling in your fingers when you laterally flex your neck to the same side. Which structure could be causing this problem?
- A.
  
  Phrenic Nerve
- B.
  
  Subclavian Artery
- C.
  
  Ansa Cervicalis
- D.
  
  Brachial plexus
14.

You remove a mass in the posterior triangle of a patient. During a post-op visit the patient complains she is having trouble brushing her hair. During a neurological exam you notice drooping of the right shoulder. Lesion to what structure in the posterior triangle could have been compromised from the surgery?
- A.
  
  Spinal accessory nerve
- B.
  
  Suprascapular nerve
- C.
  
  Ansa cervicalis
- D.
  
  Hypoglossal nerve
- E.
  
  Vagus nerve
15.

The posterior cervical triangle contains an important accessory muscle of respiration. This muscle is named______________and is innervated by Cervical Nerves_______________The posterior triangle also contains______________ .
- A.
  
  Anterior Scalene, C3-C8, Roots of the Brachial Plexus
- B.
  
  Anterior Scalene, C3-C8, Trunks of the Brachial Plexus
- C.
  
  Posterior Scalene, C3-C6, Brachial Plexus Roots
- D.
  
  Sternocleidomastoid,C3-C6, Brachial Plexus Trunks
16.

A patient comes in to the ER with a superficial incision mid way through the anterior triangle of the neck. What cutaneous nerve and nerve root is most likely to be damaged?
- A.
  
  Supraclavicular n. (C3, C4)
- B.
  
  Transverse cervical n. (C2, C3)
- C.
  
  Greater Auricular n. (C2, C3)
- D.
  
  Transverse anterior n. (C2, C3)
17.

A 26-year old man is involved in an accident and presents to your clinic afterwards for a check-up. You believe he may have a lesion in the posterior triangle of his neck, specifically the spinal accessory nerve. How would you test this nerve?
- A.
  
  Test for sensations over his face
- B.
  
  Elicit the gag reflex
- C.
  
  Examine for the power of his muscles of mastication
- D.
  
  Examine for his sense of smell, using ground coffee, for example
- E.
  
  Ask the patient to shrug his shoulder and to turn his head against resistance
18.

A patient has an infection at the tip of his tongue after a strangely placed tongue ring; which of the following triangles of the neck contain the lymph node that would primarily receive the lymph drainage from the affected area?
- A.
  
  Suboccipital Triangle
- B.
  
  Muscular Triangle
- C.
  
  Carotid Triangle
- D.
  
  Submandibular Triangle
- E.
  
  Submental Triangle